The higher my meter readings, the lower my a1c

Does anyone have any ideas about what's going on here? Before I knew I had diabetes, my a1c was around 5.4. When I suspected, and then confirmed with labs, to have LADA diabetes in 2014, I started eating low carb, and my a1c went up to 5.8, and at its highest, it was 6.0. I had just started Metformin a few months before that highest reading. When my a1c was higher, I very rarely saw meter readings above about 125 at the peak after meals, and my fasting numbers were mid-90s to around 100. Therefore, the 5.8 and 6.0 a1c readings didn't seem like they could represent my average numbers, and I wasn't concerned about it. I figured my red blood cells were just living longer or something.

Over the past couple of years, my blood sugars are creeping up a little. My morning fasting numbers usually range from about 110 to 120, and my post-prandials more often go up to around 140 to 150, and sometimes a little higher. Sometimes, they're lower than that after meals, but it's becoming much more frequent to see them that high or even higher. But the weird thing is, my a1cs are going down again. My last one was the lowest I've ever seen--5.2. Now again, my a1c can't possibly represent my average blood glucose, only this time it's showing too low instead of too high.

I haven't brought it up to my doctor, because I'm not sure yet what I want to do, but I'm toying with the idea of wanting to go on insulin, while at the same time, my doctor thinks my glucose control is just great and getting better all the time. Even my fasting glucose labs are lower than my meter, ranging from about 99 to about 103 or something like that over the past year or more. I know my meter isn't perfectly accurate, but my numbers are definitely trending upwards, while my a1c is trending downwards. Has this happened to anyone else? Does anyone know why? And if I do want to try insulin, how to I convince my doctor I need it?

Hi and welcome to DD I would kill for your numbers. As a LADA I am sorta surprised you can get those numbers it shows your pancreas is still working and it will for some. I have no idea why your a1c is going down but your lucky things are working the way they are. The doctor may think you will go low on insulin and you might, did they do GAD 65 and C peptide to confirm you were LADA.

Hi furball, I did have the antibodies with the GAD 65, but not the islet cell antibodies. My C-peptide was also low. I think the reason my numbers are so good is just that I caught this so early. I saw various doctors, including a naturopath, for pretty debilitating hypothyroid symptoms and later for symptoms of what turned out to be fibromyalgia. And in the process of various random tests that she did, I learned that I had a "poor insulin response" to a carb challenge and that I was low in insulin. Since there was clearly no indication that I had type II, especially bad enough that I was already deficient in insulin, I did some research and learned about LADA from Jenny Ruhl's website. I bought a meter and saw that my blood sugar was spiking up into the high 100s and very low 200s after eating a moderate number of carbs, so I made an appointment with an endo and asked her to test me for LADA. She was very accommodating since she didn't really think it likely, but she confirmed it with the tests. She's been seeing me ever since, and she recently left the practice, so I just started seeing a new doctor--her replacement. They have me come in every 3 or 4 months just to monitor.

But there was actually almost ten years between the first time my naturopath said I had low insulin and the time I did all this research. I saw the naturopath in 2006 for my thyroid, and then not again until 2014 for my fibromyalgia symptoms and she told me both times that my insulin was low based on a cortisol saliva test that included a carb challenge. It wasn't till 2014 that I started investigating, so apparently something was going on even in 2006. But this naturopath (she's a D.O) isn't familiar with LADA, though, so she didn't think to suspect it.

I actually think it possible that I may never progress enough that my pancreas poops out completely, though since I've progressed so slowly in so many years. But who knows?

reezers, welcome to DD!
Going on insulin isn't as horrible as I originally thought. But that has taken me almost two years to say. You see, I was a person who rarely saw a doctor, never had health issues, no history of either type in my family so no reason to ever think about D, and hates taking meds of any kind.
I had no honeymoon period. I was put on basal one day after dx and fast-acting about a week later.
It took me a lot longer to get them to test my c-peptide (mine is less than 0.1; I make no insulin of my own) and change my designation to 1.5. You are fortunate that you have that designation from the start.
The learning curve is on-going for me, cuz my insulin needs are constantly changing. Just when things have been going along well for more than a few weeks, I'll start having lows or highs and then the tweaking of doses starts. That's pretty much life w/ D, at least for me.
But I have learned more here from D.D. than I ever have from my docs and DE's. This is a great community with a wealth of information and helpful insights. Welcome, again!

Eating low carb when your a1c was that low to begin could raise it. The simple reason is that when you eat carbs you spike higher and quicker. With proteins and fats, you'll stay elevated longer. So if you are eating more frequently and lower carb, your blood sugar on average should actually be higher because it is slightly elevated for longer. If you look at it like a calculus equation it's all about the area under the curve of the spike.

Example: (4 hour window)
Let's say you were at 90 and you ate some carbs, so say over an hour you go to up to 140 and back down to 90 and stay there for the next three hours hours. Your average BG over those 4 hours would only be be 96.25 (first hour 115, hours 2-4 90)

Let's say you ate something that was low carb but full of fats and proteins. You started at 90 and at 2 hours you peak at 120 and then get back to 90 at the end of 4 hours. Your average over those 4 hours would actually be 105 over that whole 4 hour period

If there us a huge discrepancy between your meter reading and what the blood test shows you are at the time your blood is drawn, not your a1c, have you considered switching meters just to see if you are not getting more expected numbers with a different meter? Sone meters are said to be more accurate than others.

Thanks, all, for the welcome and the responses. I kind of forgot about this thread after a few days when I didn't see any answers that applied to my situation. The response from brooksd seems close, but not quite it. My blood sugar was staying high for a long time before I started eating low carb, and going low carb made it stop spiking at all because I wasn't eating enough carbs to raise my blood sugar too much. But I started taking a few more liberties in the past year or so, and while I do get higher numbers on those occasions, I still eat mostly low carb and things don't seem to be progressing. It may be the case that my higher a1c during my lowest carb eating has to do with the fact that eating low carb tends to lower insulin production even for a healthy pancreas, and probably did so for my unhealthy one as well. At least that's how I understand it from reading some paleo websites.

Anyway, it's been more than three years since my diagnosis and about eleven years since I first had evidence of low insulin production, and I don't think things have progressed much, so I'm somewhat optimistic that things might stay static indefinitely. But if not, I'll deal with it as it comes. I have used a few different meters, but the one I use now seems pretty reliable and consistent, and it's one that my insurance company will pay for the test strips, so I'm sticking with it. It's good enough for my purposes.